Pirarubicin, a novel derivative of doxorubicin. THP-COP therapy for non-Hodgkin's lymphoma in the elderly.
Pirarubicin (tetrahydropyranyl adriamycin, THP) is a derivative of doxorubicin. Forty-three non-Hodgkin's lymphoma (NHL) patients 65 years of age or older were treated with a combination therapy including cyclophosphamide (CPA), vincristine (VCR), prednisone (PSL), and THP (THP-COP). The THP-COP regimen consisted of THP, 30 mg/m2 i.v. on day 1; CPA, 500 mg/m2 i.v. on day 1; VCR, 1.0 mg/m2 i.v. on day 1; and PSL, 60 mg orally for 5 consecutive days. The sequence was repeated at 21- to 28-day intervals for a minimum of four cycles. Of the 43 patients, 13 (30.2%) achieved a complete response (CR) and 21 (48.8%) a partial response (PR). Nine patients (21.0%) had primary treatment failure, which included a minimal response, no change, and progressive disease. Thus, the response rate (CR or PR) was 79.1%. Twenty-six of 29 previously untreated patients (89.7%) achieved a CR or PR, whereas only 8 of 14 previously treated patients (57.1%) did (p less than 0.05). Because THP is a derivative of doxorubicin, the results for the eight patients previously treated with doxorubicin are noteworthy; four achieved a CR or PR. No patients had any cardiac toxicity, including congestive heart failure, attributable to THP. Furthermore, four patients who showed a decreased ejection fraction before treatment completed the full course of THP-COP chemotherapy without any progression of the cardiac complication. THP is considered to be active against NHL in the elderly and comparable to doxorubicin in combination chemotherapy.
Kitamura
K
K
Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
Takaku
F
F
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone